HomeMy WebLinkAboutM2019-0066 - Permitsr• City of Newport Beach - Building Division
a4 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counteriahone (949)644-3288
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Job Address: 1140 BAY AVE W Floor: Suite: Bldg: 0
Description of Work: SFR - REDECKING OF PIER & GANGWAY W/NEW AZEK DECKING "LIKE FOR LIKE"
2054-2019
I e for Area- 1
Ins
HARBOR Permit: M2019-0066
Project No: 2054-2019
Inspection Requests Phone (949)644-3255
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Inspection Feer
$297.00
Plan Check Fee
$312.00
OT Plan Check Fee:
$0.00
Legal Description: N TR 626 BILK 4 LOT 1
$0.00
Building Green Fee :
$1.00
.°°°
Owner:
WELLS JOHN & JANET
Contractor:
SWIFT SLIP DOCK/PIER BUILDERS
Engineer:
PETROV PLAMEN
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Address:
1140WBAY AVE
Address:
6351INDUSTRYWAY
Address:
28161 CASITAS CT
NEWPORT BEACH CA 92661
WESTMINSTER CA 92683
LAGUNA NIGUEL CA 92677
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Phone:
Phone:
949-631-3121
Phone:
714-717-7542
State Lica
C-066947
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Applicant:
CHUNG JACQUELYN
Cod StateLic:797052
Designer.
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Address:
6351 INDUSTRY WAY
Lic Expire:
07/31/2021
Address:
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WESTMINSTER CA 92683
Bus Lic
BT01122734
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Phone:
949-631-3121
LicED
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Special Cond:
Issued Date 09/20/2019
Valuation:
$2,000.00
Inspection Feer
$297.00
Plan Check Fee
$312.00
OT Plan Check Fee:
$0.00
Investigation Fee:
$0.00
Building Green Fee :
$1.00
TOTAL FEE: $751.00
Longshoremen's and Harbor Workers' Compensation D862istion -
P1 C
Carrier: AMERICAN LONGSHOR
PolON THE WEEKEND ExDIre:123120No:09662-01
Plan Check Fee : $447.00
$0.00
Plan Dep - Counter Review: $0.00
Plan Dep - Zoning Plan Check: $0.00
Plan Dep - OverTime Plan Check: $0.00
PROCESSED BY: PUBLIC WORKS:
PLAN CHECK BY: Ci APPROVAL TO ISSUE: _
OTHER DEPARTMENTS:
FINAL INSPECTION: _
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at permit Issuance : $304.00
FEES
Fire Inspection Fee:
$0.00
Fire Plan Check Fee:
$0.00
Records Mangement:
$6.00
Harbor Plan Check Fee:
$135.00
Plan Check Fee : $447.00
$0.00
Plan Dep - Counter Review: $0.00
Plan Dep - Zoning Plan Check: $0.00
Plan Dep - OverTime Plan Check: $0.00
PROCESSED BY: PUBLIC WORKS:
PLAN CHECK BY: Ci APPROVAL TO ISSUE: _
OTHER DEPARTMENTS:
FINAL INSPECTION: _
PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION
Fee Due at permit Issuance : $304.00
NNER-BUILDER DECLARATION _
I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s)
action 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant f:
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 76110) of Division 3 of the Business an
)fessions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty c
more than five hundred dollars ($500).
I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or L) portions of the work, and the structure is not intended or offered for sale (Section 7044,
siness and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that th
)rovements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built c
)roved for the -purpose of sale).
I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does no
Ay to an owner of property who builds or improvesthereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). -----
I am exempt from licensure under the Contractors'. State License Law for the following reason:
my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legall
I a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business aro
Ifessions Codi y is•available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htmi.
nature of Prvperty Qwner or Authorized Agent Date
NFED C.0"J"CTOR'S DECLARATION
by affirm under -penalty of perjury that I am licensed under provisions of Chapter 9 (comma eing with Section 7000) of Division 3 of the Business and P f5 Bions ede, and my license is in full fore
nett. License. Class License No. Date Y 2 0 //9• Contractor Signature
BSHOREMEN:i' & HARBOR WORKERS' COMPENSATION DECLA ATION
1 :: FAILUR4' J SSEQ•URE LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL• ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
101, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one Of the followlnc
ations. ,"",
1�'I have an(fwill maintain Longshoremen's and Harbor workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
My workers' compensation insurance carrier and policy number are:
r • «• Policy Number Expiration Date
o Agent Phone #
• I certil #A,. n the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, an
Pat, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
rture o plicant,
ii's �;, Date:/1v
:AfEfMWREGARDING CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code)
Lender's Name Lender'sAddress
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
I have read this application and the information I have provided is correct.
I agree to comply with all applicable city and county ordinances and state laws relating to building construction.
I authorize representatives of th' ity or county to enter the above -identified property for inspection purposes.
iinnature: / j print Nam �Y/2M vG /l /"� �(% V� O"V' na4a•
ACRO DATE BY UCUL a MUM yr L:umrLurLIYVC"I r IT wvC yr FUR vftftt U5t 471VLY
FEDERAL REGULATIONS PART 01 OF 77TLE40AND.
PERMITEX O AQMDRULE 1403.
1 SUBMITTED ASBESTOS NORFICAT101V TO:
PERMITCA.NCELLED ❑ EPA
PERMIT EXTENDED ❑ AQMD
ASBESTOS NQTLflCATIONIS NOT APPLICABLE TO
PERMITFINAL 1.7 PROPOSEDDEMOLITION,
CERTIFICATEOF
OCCUPANCYISSUED SIGNATURE;
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